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目的探讨高血压性丘脑出血的临床特点和预后。方法回顾性分析2002年—2010年在北京天坛医院住院治疗的503例高血压性丘脑出血病例的资料,总结患者的合并症情况及住院期间的临床转归。结果在503例患者中,431例患者(85.7%)获得长期存活。并发肺部感染71例(16.5%),脑积水15例(3.8%),其中6例接受了脑室腹腔引流术。应激性溃疡30例(7.6%),下肢深静脉血栓15例(3.8%),其中3例接受静脉滤器植入术。住院期间死亡72例,占14.3%(72/503)。死亡原因包括脑疝43例(59.7%),肺部感染27例(37.5%),颅内感染2例(2.8%)。结论高血压性脑出血多见于老年人,病情重,预后差,外科治疗不能明显降低患者死亡率,肺部感染等并发症与患者预后不良明显相关。
Objective To investigate the clinical characteristics and prognosis of hypertensive thalamic hemorrhage. Methods The data of 503 cases of hypertensive thalamic hemorrhage hospitalized in Beijing Tiantan Hospital from 2002 to 2010 were analyzed retrospectively to summarize the patients’ comorbidity and the clinical outcome during hospitalization. RESULTS Of the 503 patients, 431 patients (85.7%) had long-term survival. Pulmonary infection in 71 cases (16.5%), hydrocephalus in 15 cases (3.8%), of which 6 cases received intraventricular drainage. 30 cases (7.6%) of stress ulcer and 15 cases (3.8%) of deep venous thrombosis of lower extremity. Three of them received venous filter implantation. During hospitalization, 72 patients died, accounting for 14.3% (72/503). The causes of death included 43 cases of herniation (59.7%), 27 cases of pulmonary infection (37.5%) and 2 cases of intracranial infection (2.8%). Conclusion Hypertensive intracerebral hemorrhage is more common in the elderly, with severe illness and poor prognosis. Surgical treatment can not significantly reduce the mortality rate and the complications such as pulmonary infection are significantly associated with poor prognosis.